Increased incidence of invasive group A beta hemolytic streptococcal infections in children

Abstract

Group A beta hemolytic streptococci (GAS) can cause a wide range of mild infections but they are associated with severe infections with high morbidity and mortality rates. Risk factors for invasive GAS infections in children include antecedent varicella zoster infection. There is an increasing incidence of invasive GAS infection caused by clonal strains leading to outbreaks in the last decade. We describe four pediatric patients with severe conditions caused by GAS, leading to intensive care support in two patients. Two of the patients had antecedent varicella infection. A single clone of group A streptococcus was responsible in all children. Routine varicella vaccination is not currently part of the health programs of many countries, including The Netherlands. One benefit of universal varicella vaccination would be the prevention of some cases of pediatric invasive GAS disease, leading to a decrease in hospitalization, morbidity and mortality rates.